| NPI | 1770101925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WILSON Owner 909-267-5740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |